{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:42:14Z","timestamp":1790023334529,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pre\u2010eclampsia (PE) causes substantial maternal and neonatal mortality and morbidity. In addition to the personal impact on women, children and their families, PE has a significant economic impact on our society. Recent research suggests that a first\u2010trimester multivariate model is highly predictive of preterm (&lt;\u200937\u2009weeks' gestation) PE and can be combined successfully with targeted prophylaxis (low\u2010dose aspirin), resulting in an 80% reduction in prevalence of disease. The aim of this study was to examine the potential health outcomes and cost implications following introduction of first\u2010trimester prediction and prevention of preterm PE within a public healthcare setting, compared with usual care, and to conduct a cost\u2010effectiveness analysis to inform health\u2010service decisions regarding implementation of such a program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision\u2010analytic model was used to compare usual care with the proposed first\u2010trimester screening intervention within the obstetric population (<jats:italic>n<\/jats:italic>\u2009=\u20096822) attending two public hospitals within a metropolitan district health service in New South Wales, Australia, between January 2015 and December 2016. The model, applied from early pregnancy, included exposure to a variety of healthcare professionals and addressed type of risk assessment (usual care or first\u2010trimester screening) and use of (compliance with) low\u2010dose aspirin prescribed prophylactically for prevention of PE. All pathways culminated in six possible health outcomes, ranging from no PE to maternal death. Results were presented as the number of cases of PE gained\/avoided and the incremental increase\/decrease in economic costs arising from the intervention compared with usual care. Significant assumptions were tested in sensitivity\/uncertainty analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intervention produced, across all gestational ages, 31 fewer cases of PE and reduced aggregate economic health\u2010service costs by 1\u2009431\u2009186\u2009Australian dollars over the 2\u2010year period. None of the tested iterations of uncertainty analyses reported additional cases of PE or higher economic costs. The new intervention based on first\u2010trimester screening dominated usual care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This cost\u2010effectiveness analysis demonstrated a reduction in prevalence of preterm PE and substantial cost savings associated with a population\u2010based program of first\u2010trimester prediction and prevention of PE, and supports implementation of such a policy. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22193","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T17:20:10Z","timestamp":1599067210000},"page":"688-697","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Cost\u2010effectiveness analysis of a model of first\u2010trimester prediction and prevention of preterm pre\u2010eclampsia compared with usual care"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-4767","authenticated-orcid":false,"given":"F.","family":"Park","sequence":"first","affiliation":[{"name":"Department of Maternal Fetal Medicine John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5418-3936","authenticated-orcid":false,"given":"S.","family":"Deeming","sequence":"additional","affiliation":[{"name":"Health Research Economics Hunter Medical Research Institute Newcastle Australia"},{"name":"School of Medicine and Public Health, College of Health, Medicine and Wellbeing University of Newcastle Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8019-1289","authenticated-orcid":false,"given":"J.","family":"Hyett","sequence":"additional","affiliation":[{"name":"Sydney Institute for Women Children and their Families, Royal Prince Alfred Hospital Sydney Australia"},{"name":"Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.042"},{"key":"e_1_2_8_3_1","unstructured":"The Preeclampsia Foundation.Advocacy and Awareness.https:\/\/www.preeclampsia.org\/the\u2010news\/legislative\u2010advocacy\/worldpreeclampsiaday. 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